Kornimate/medical-research-clean huggingface dataset:
quantifying collateral perfusion in cerebrovascular disease-moyamoya disease and stroke patients

Conditions: Cerebrovascular Accident; Moyamoya Disease

Summary: quantifying collateral perfusion in cerebrovascular disease-moyamoya disease and stroke patients

in the early hours following large vessel occlusion, the ultimate severity of the stroke is largely determined by the ability of collateral flow networks to supply blood to ischemic tissue via circuitous routes that bypass the proximal clot. robust collateral flow can improve response to thrombolytic therapy and decrease the risk of intracranial hemorrhage. despite their central importance, collaterals during acute stroke are poorly understood, largely because assessment has required an invasive imaging test, cerebral angiography. this proposal assesses whether a noncontrast mri perfusion technique, called arterial spin labeling (asl), can yield important information about collateral flow.

Eligibility criteria:
inclusion criteria: moyamoya patient inclusion criteria: * men and non-pregnant women, at least 21 years of age. * outpatients seen at the stanford neurosurgery and neurology departments. * ability to comply with all studies. * inclusion of moyamoya patients with sulfa allergies. * patients diagnosed with or suspected to have moyamoya disease. stroke patient inclusion criteria: * men and non-pregnant women, at least 21 years of age. * patients admitted to the inpatient stanford stroke service for stroke-like symptoms, less than 24 hours from last time seen normal. * ability to comply with all studies. clinical patient acetazolamide mri inclusion criteria: * men and non-pregnant women, at least 21 years of age. * patients admitted to the inpatient stanford stroke service or neurosurgical -service for symptoms compatible with cerebrovascular disease. * ability to comply with all studies. normal subject inclusion criteria: * ability to comply with the mri study. exclusion criteria: * level of consciousness score of 2 or greater as defined by the nih stroke scale. * symptoms likely related to psychoactive drugs or patients with symptoms related to an active inflammatory disease such as aids, meningitis, or cerebritis. * psychiatric or substance abuse disorder or dementia that interferes with evaluation or interpretation of the neurologic and mental assessment of these patients. * informed consent cannot be obtained either from the patient or legal representative. * severe coexisting or terminal systemic disease that limits life expectancy or that may interfere with the conduct of the study. * symptoms related to an alternative diagnosis such as seizures or migraine. * patients receiving any thrombolytic agent or receiving acute stroke investigational drug therapies during the 30-day study.
high-dose bevacizumab in advanced renal carcinoma patients

Conditions: Renal Cancer; Kidney Cancer

Summary: this trial will examine the effectiveness and the side effects of 2 higher dosing schedules of bevacizumab in patients that have advanced clear cell renal carcinoma.

bevacizumab is considered a targeted drug. targeted drugs act on specific receptors on a cell. bevacizumab blocks receptors that help cancer cells develop blood supplies so that the cancer can grow. these specific receptors are found in greater numbers in kidney cancer. in that regard bevacizumab will be tested in 2 doses that are higher than non-kidney cancer treatments with bevacizumab. one group of patients will receive bevacizumab at 15 mg per kg by vein every 2 weeks. a total of 75 patients will be treated with this dose. if this dose is well tolerated a second group of patients will receive bevacizumab at 15mg per kg by vein weekly.

Eligibility criteria:
inclusion criteria: * histologically documented metastatic or unresectable locally recurrent clear cell renal carcinoma * previous kidney removal is required except if the primary tumor was smaller than 5 cm or there was extensive liver or bone metastasis * patients may have received a maximum of 1 prior systemic treatment of immunotherapy (interferon, il-2), chemotherapy, or combination chemo+immunotherapy for metastatic disease. * no prior bevacizumab * measurable disease * adequate liver and kidney function * age 18 and older exclusion criteria: * acute mi within the past 6 months * uncontrolled high blood pressure or history of hypertensive crisis * clinically significant cardiovascular disease * active brain cancer * meningeal metastasis * pregnant or lactating women * prior treatment for another cancer less than 5 years ago * no diseases of the central nervous system (eg. uncontrolled seizures, strokes or tias * no bleeding from the mouth, rectum or coughing up blood or history of other bleeding or clotting disorders * no history of deep vein thrombosis less than 12 months ago or are currently requiring full dose anticoagulation * no major surgical procedures, open biopsies or traumatic injury in past 28 days * no patients with peg tubes or feeding tubes * no patients with non healing wounds, ulcers or long bone fractures * no history of abdominal fistulas, gastrointestinal perforation or intrabdominal abscess within 6 months * no symptomatic peripheral vascular disease please note: there are additional inclusion/exclusion criteria. the study center will determine if you meet all of the criteria. if you do not qualify for the trial, study personnel will explain the reasons. if you do qualify, study personnel will explain the trial in detail and answer any questions you may have. you can then decide if you wish to participate.

Keywords: kidney cancer renal cancer clear cell carcinoma
high-activity natural killer immunotherapy for small metastases of non-small cell lung cancer

Conditions: Non-small Cell Lung Cancer Metastatic

Summary: the aim of this study is the safety and efficacy of high-activity natural killer immunotherapy to small metastases of non-small cell lung cancer.

by enrolling patients with small metastases of non-small cell lung cancer adapted to enrolled criteria, this study will document for the first time the safety and the short and long term efficacy of high-activity natural killer cells. the safety will be evaluated by statistics of adverse reactions. the efficacy will be evaluated according to local relief degree, progress free survival (pfs) and overall survival (os).

Eligibility criteria:
inclusion criteria: * all standard therapies have failed according to nccn guidelines or the patient refuses standard therapies after cancer recurrence * body tumor 1-6, the maximum tumor length \< 2 cm * kps ≥ 70, lifespan \> 6 months * platelet count ≥ 80×109/l，white blood cell count ≥ 3×109/l, neutrophil count ≥ 2×109/l, hemoglobin ≥ 80 g/l exclusion criteria: * patients with cardiac pacemaker * patients with brain metastasis * patients with grade 3 hypertension or diabetic complication, severe cardiac and pulmonary dysfunction

Keywords: metastatic lung cancer high-activity natural killer
efficacy, usability study of the glucotab system for glycaemic management in type 2 diabetic patients at general wards

Conditions: Type 2 Diabetes

Summary: objective: to investigate the performance (safety) of the glucotab system for glycaemic management in non-critically ill patients with type 2 diabetes at general wards.


Eligibility criteria:
inclusion criteria: * informed consent obtained after being advised of the nature of the study * male or female aged ≥18 years * type 2 diabetes (treated with diet, oral agents, non-insulin injected anti-diabetic medicine, insulin therapy or any combination of the four) or newly diagnosed hyperglycaemia which requires s.c. insulin therapy exclusion criteria: * type 1 diabetes, gestational diabetes * any disease or condition which the investigator or treating physician feels would interfere with the trial or the safety of the patient * pregnancy * any mental condition rendering the patient incapable of giving his consent * known or suspected allergy to insulin glargine or insulin aspart * continuous parenteral nutrition * participation in another trial which can influence the software algorithm
fenretinide in treating patients with cervical neoplasia

Conditions: Cervical Cancer; Precancerous Condition

Summary: rationale: chemoprevention uses drugs to try and prevent development of cancer. fenretinide may be effective in treating cervical neoplasia and preventing cervical cancer. purpose: randomized double-blinded phase iii trial to compare the effectiveness of fenretinide to placebo in treating patients with cervical neoplasia.

objectives: i. determine the efficacy of fenretinide (n-(4-hydroxyphenyl) retinamide; 4-hpr) at regressing cervical intraepithelial neoplasia (cin). ii. document the qualitative and quantitative toxicity of 4-hpr in women with cin. outline: this is a double blinded study. patients are randomized to receive either fenretinide or placebo. patients are administered fenretinide or a placebo by mouth (po) daily for 6 months with 3 days of rest every month. patients undergo colposcopy, colpophotography, and pap smears at 3, 6, 9, and 12 months. patients undergo cervical biopsy at 6 and 12 months to assess changes. projected accrual: 84-100 patients will be accrued.

Eligibility criteria:
disease characteristics: histologically diagnosed new or recurrent cervical intraepithelial neoplasia grade 2-3 lesion involving at least one quadrant of the transformation zone of the cervix patient characteristics: age: 18 and over performance status: zubrod 0-2 life expectancy: at least 12 months hematopoietic: absolute granulocyte count greater than 1500/mm3 platelet count greater than 100,000/mm3 hepatic: bilirubin no greater than 1.5 mg/dl renal: creatinine no greater than 1.5 mg/dl other: fertile patients must use effective contraception fasting triglyceride less than 2 times normal no prior malignancy must consent to colposcopy and cervical biopsy prior concurrent therapy: not specified

Keywords: cervical cancer cervical intraepithelial neoplasia grade 2 cervical intraepithelial neoplasia grade 3
treatment of myelodysplastic syndromes comparing hydralazine/ac. valproic and supportive care in patients not candidates, refractory and/or intolerant to intensive chemotherapy

Conditions: Myelodysplastic Syndrome

Summary: transfusional dependence has been associated closely and independently with low survival in patients with myelodysplastic syndrome (mds), especially in patients at low risk according to ipss. treatment of patients with hydralazine + valproic acid as an alternative to treatment with 5-azacytidine has lower cost and possibly as effective with fewer side effects. the objective of this phase ii study is to determine the effectiveness of combination therapy with hydralazine + ac. valproic compared with best supportive care. the investigators will select 42 patients per group, and after 14 weeks of treatment the investigators will study in both groups the hematological response (transfusion-dependent, hemoglobin, cytogenetics and morphology) and treatment safety (adverse reactions and vital signs) to 1 year after starting treatment. the concentration of hemoglobin, the number of transfusions, platelets, neutrophils and other continuous variables in both groups will be compared by student t or mann-whitney, as appropriate. for comparison of cytogenetic and morphological response and other categorical variables between groups chi square will be used. and within each group the investigators will compare each of these variables before and after treatment by t-test for paired data or wilcoxon test.


Eligibility criteria:
inclusion criteria: 1. ability to understand and voluntarily sign the consent form. 2. age ≥ 18 years at the time of signing the informed consent form. 3. ability and willingness to meet the schedule of study visits and other protocol requirements. 4. documented diagnosis of smds according to the criteria of disease risk ipss intermediate-2, high risk or any risk with transfusion requirements. 5. transfusion-dependent anemia erythrocytes defined as the absence of a period of 56 consecutive days without transfusion of red blood cells for at least 112 days prior (16 weeks). 6. engage both women and men to use highly effective contraception. 7. patients are not candidates for treatment with azacitidine or chemotherapy exclusion criteria: * patients who have any of these exclusion criteria may not be included in the trial: 1. pregnant or breastfeeding. 2. after hematopoietic stem cell transplantation. 3. patients with vitamin b12 deficiency, folic acid and iron 4. any severe psychiatric illness or condition that prevents the patient sign the consent form for the patient or involves an unacceptable risk in case of participating in the study. 5. hypersensitivity to hydralazine and / or ac. valproic

Keywords: myelodysplastic syndrome transfusion hydralazine valproic acid
erector spinae plane (esp) block for renal colic

Conditions: Renal Colic

Summary: comparing standard of care to erector spinae plane block for acute renal colic pain.

will compare at times 0, 10 minute, 20 minute, 40 minute and 60 minutes after local nerve block given.

Eligibility criteria:
inclusion criteria: * 18 to 65 years old * asa level i and ii * flank pain concerning for renal colic in ed exclusion criteria: * pregnant women * subjects unable to appreciate esp block landmarks under ultrasound * skin infection over needle site insertion * allergy to local anesthesia (lidocaine/ropivacaine) * bleeding disorders * serious cardiac, lung, liver or kidney dysfunction * history of spine surgery * history of spinal infection * history of epidural injection within 6 months * acute exacerbation of serious mental disease * unable to consent * unable to communicate pain level

Keywords: erector spinae plane block
efficacy of megadose vitamin c in severe and critical ill covid-19 patients.

Conditions: Vitamin C; COVID-19 Pneumonia

Summary: the main aim is to determine whether vitamin c can reduce 28-day all-cause mortality or persistent organ dysfunction compared with placebo in patients with severe and critical ill covid-19 patients. participants will randomly receive hivc or placebo for 4 days once enrolled. the primary outcome is a composite of death or persistent organ dysfunction (defined as dependency on vasopressors, mechanical ventilation, or crrt) at day 28 after randomization.


Eligibility criteria:
inclusion criteria: 1. adults (age 18 years or older). 2. diagnosed with covid-19 according to the diagnosis and clinical management of covid-19. (trial version 10). 3. severe and critical ill patients with covid-19. 4. patients who voluntarily participate in the study and sign the informed consent form. exclusion criteria: 1. patients with a history of allergy to vc. 2. pregnant or lactating women. 3. patients with end-stage malignant tumour. 4. patients with an expected survival duration of less than 24 hours. 5. patients with cerebral hernia and severe craniocerebral injury. 6. patients with diabetes. 7. patients with a previous history of g-6-pd deficiency.

Keywords: vitamin c covid-19
dairy intervention in people with obesity

Conditions: Obesity

Summary: obesity is associated with increased morbidity and mortality, but weight reduction is difficult to achieve. in this randomized controlled trial we will include 120 obese subjects. subjects will be allocated to one of the 3 diet types (minus 500 kcal / d): * yoghurt diet: 500 g low-fat yogurt / d, about 1000-1100 mg calcium / d, * milk product diet: 500 g of low-fat milk or buttermilk / d, about 1000-1100 mg calcium / d * standard diet: 500 g soy yogurt / d, about 500 mg calcium / d primary endpoint is the change in fat mass (baseline vs. 12 weeks), secondary endpoints are metabolic and endocrine parameters, gut microbiome, quality of life, hunger and satiety.


Eligibility criteria:
inclusion criteria: * bmi ≥30 kg/m² * age of ≥18 and \<60 years * written informed consent before study entry * willingness to introduce a dietary change to lose weight exclusion criteria: * serum calcium ≥2.7 mmol/l * dislike or intolerance of dairy products, reporting adverse responses or allergy to dairy products * pregnancy or lactating women * having given birth in the last year or planning a pregnancy in the next 6 months * menopause (as defined by fsh levels ≥30 iu/l) * disorders associated with androgen excess and/or menstrual irregularities except pcos (overt thyroid dysfunction, hyperprolactinemia, adrenal hyperplasia, androgen secreting tumors) * malabsorption syndrome * intake of medication influencing metabolic or endocrine parameters (insulin sensitizers, oral contraceptives, ...), obesity pharmacotherapeutic agents, or calcium supplements in the last 3 months before study entry * regular intake of calcium supplements in the last 3 months before study entry * lifestyle changes (changes in physical activity) or weight reduction (≥10% of body weight) in the last 3 months before study entry

Keywords: yogurt dairy calcium weight reduction obesity randomized controlled trial body composition microbiome
rossini 2 - reduction of surgical site infection using several novel interventions

Conditions: Surgical Site Infection; Surgical Wound Infection; Surgery--Complications; Surgery

Summary: rossini 2 is a phase iii, multi-arm, multi-stage (mams) pragmatic, blinded (patient and outcome assessor), multicentre, randomised controlled trial (rct) with an internal pilot, to evaluate the use of several in-theatre interventions, used alone or in combination, to reduce ssi rates in patients undergoing surgery.

the primary objective of rossini 2 is to determine whether several specific in-theatre interventions, used alone or in combination, result in decreased rates of surgical site infection (ssi) up to 30 days post operation in adult patients undergoing abdominal surgery. at least 60 nhs hospitals in the uk will participate in rossini 2. approximately 6610 patients will be required to detect a 5% absolute risk reduction in the intervention arm(s) (15% to 10%; 33% relative reduction) with 85% power. initially, the three health technologies that were assessed versus the control arm (standard care) were: 1. 2% alcoholic chlorhexidine skin preparation, versus any other standard skin preparation 2. iodophor-impregnated incise drape, versus no drape 3. gentamicin-impregnated implants/ sponge at closure, versus no implant please note: in january 2022, following the first interim analysis, arms including intervention 2 - iodophor-impregnated incise drape (arms c, e, g and h) were closed to recruitment.

Eligibility criteria:
inclusion criteria: * patients undergoing colorectal, hepatobiliary, upper gi, urological, vascular, or gynaecological operations * patients undergoing abdominal operations (open or laparoscopic extraction site) with a planned incision of at least 5cm. * patients aged 16 years or older * patients able and willing to undergo a wound assessment at day 30-37 after surgery * patients able and willing to give written informed consent * all contamination strata, including clean, clean-contaminated, contaminated or dirty surgery. * patients undergoing planned (elective or expedited) or unplanned (emergency) surgery. exclusion criteria: * previous laparotomy within 3 months prior to randomisation * known to be pregnant or currently breast feeding * operations where the wound is not anticipated to be closed primarily * patients with a new or documented allergy/ intolerance to any of the study interventions (chlorhexidine, iodine, collagen or gentamicin) will not be randomised to an arm containing this intervention, but will still be eligible for recruitment to other arms of the study. * patients with end-stage renal failure where gentamicin administration would otherwise be contra-indicated (according to local policy) will not be randomised to arms containing the gentamicin-impregnated sponge.

Keywords: ssi surgical site infection infection prevention mams multi-arm, multi-stage pragmatic abdominal surgery multicentre rct pilot chlorhexidine skin prep iodophor drape gentamicin sponge surgery
a study to assess the pharmacokinetics, safety and tolerability of sitagliptin in adolescents (0431-081)

Conditions: Type 2 Diabetes

Summary: this study will assess the safety, tolerability and pharmacokinetics of sitagliptin in 10 to 17 year old diabetic patients.


Eligibility criteria:
inclusion criteria: * males or females who are 10 - 17 years of age * history of type 2 diabetes * nonsmoker * no clinical or laboratory evidence to indicate a diagnosis of type 1 diabetes exclusion criteria: * history of diabetic ketoacidosis * history of stroke, chronic seizures or major neurological disorder * consumes alcohol * consume more than 6 servings (1 serving is approximately equivalent to 120 mg of caffeine) of coffee, tea, cola or other beverages containing caffeine per day * unable to swallow tablets * has had surgery, donated or lost 1 unit of blood, or participated in another investigational study within a minimum of 4 weeks prior to starting the study * history of multiple and/or severe allergies or has had an allergic reaction to or significant intolerability to prescription or non-prescription drugs or food * currently a regular user of any illicit drugs or has a history of drug or alcohol abuse * history of clinically significant endocrine, gastrointestinal, cardiovascular, hematological, hepatic, immunological, renal, respiratory, or genitourinary abnormalities or diseases * has an estimated creatinine clearance of less than or equal to 80 ml/min
assessment of postoperative pain in children with facial expression analysis

Conditions: Pain, Postoperative

Summary: the present study was conducted to evaluate the use of computer-aided facial expression analysis to assess postoperative pain in children. the study population consisted of patients in the age group of 7-18 years who underwent surgery at bursa uludağ university faculty of medicine health application and research hospital pediatric surgery clinic between november 2019 and june 2021. the sample of the study consisted of total 83 children who agreed to participate in the study and who met the sample selection criteria. data were collected by the researcher using the wong baker faces (wbs) pain rating scale and visual analog scale (vas). data were collected from the child, mother, nurse, and one external observer. facial action units associated with pain were used for machine estimation. openface was used to analyze the child's facial action units and python was used for machine learning algorithms. intraclass correlation coefficient, kappa coefficient, and linear regression analysis were used for statistical analysis of the data. the pain score predicted by the machine and the pain score assessments of the child, mother, nurse, and observer were compared.


Eligibility criteria:
inclusion criteria: * the patient is awake and oriented after the surgery, * the patient must be within the first 12 hours after the operation and not be discharged before the first 36 hours after the operation, * the patient is between the ages of 7-18, * it is the mother's staying with the patient as a companion. exclusion criteria: * presence of any facial anomalies that may alter facial expression analysis, * the patient has neurological and mental disorders, * having regular opiate use in the last 6 months, * these are surgical procedures that require the patient to be in a prone position.

Keywords: children facial expression analysis machine learning pain assessment